BACKGROUND: Post-herpetic neuralgia is the most serious one of herpes zoster complications and its incidence becomes higher as the age of the patient increases. Nevertheless, besides considering the age and onset time of treatment, there is no more objective factor estimating the prognosis of post- herpetic neuralgia. OBJECTIVE: The aim of this study is to understand the progression of herpes zoster and estimate the prognosis of post-herpetic neuralgia by practicing electrodiagnostic tests to patients with herpes zoster. METHODS: We evaluated the pain scales in 26 patients with herpes zoster on the first visit and 2 months later. We also performed electrodiagnostic tests, more objective and reproducible methods, including somatosensory evoked potentials and motor nerve conduction studies on both the involved and uninvolved sites of 32 lesions in 26 patients with herpes zoster, and then compared the results with the change of pain scales. RESULTS: 1. The pain category scale and visual analogue scale on the second examination were significantly decreased compared with those on the first examination (P<0.05). 2. Latencies of intercostal somatosensory evoked potentials recorded on scalp and spine were significantly delayed in involved sides compared with those in uninvolved sides (P<0.05). 3. In the latencies and conduction velocities of motor nerve conduction studies, no significant differences were seen between involved sides and uninvolved sides. 4. On the second examinataion, latency differences of somatosensory evoked potentials were significantly improved compared with those on the first examination (P<0.05). 5. Among the various somatosensory evoked potentials parameters, P1 latency difference of cortical somatosensory evoked potentials between involved and uninvolved sides correlated significantly with pain category scale ard visual analogue scale on second examination (r=0.48, P<0.05; r =0.51, P<0.05, respectively). N1 latency difference of spinal somatosensory evoked potentials between involved and uninvolved sides correlated significantly with a visual analoge scale on the first examination and pain category scale on the second examination (r=0.61, P<0.05; r=0.78, P<0.05, respectively). CONCLUSION: Intercostal somatosensory evoked potentials can be a useful and reliable technique to predict the development and severity of post-herpetic neuralgia.
Evoked Potentials, Somatosensory ; Herpes Zoster* ; Humans ; Incidence ; Neural Conduction ; Neuralgia* ; Prognosis ; Scalp ; Spine ; Weights and Measures

Thyrotoxicosis (thyroid crisis) is a known cause of sudden death; however, only a few cases of death resulting from thyrotoxicosis have been reported. Histopathologic examination and postmortem thyroid function tests may be helpful in postmortem diagnosis, but their usefulness seems to be limited. We report three autopsy cases associated with thyrotoxicosis.
Autopsy ; Death, Sudden ; Thyroid Crisis ; Thyroid Function Tests ; Thyrotoxicosis

Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis

PURPOSE: The objective of this study was to survey potential candidates for bariatric/metabolic surgery for procedure preferences. METHODS: Questions asked were divided into 5 categories: (1) demographic and anthropometric data, comorbidities, and favored surgery; (2) awareness of safety, effectiveness, and complications of each type of surgery; (3) discordances in opinion between self-selected and medically recommended procedures; and (4, 5) reasons for/against particular surgery. RESULTS: From 1 October to 15 November 2018, 104 respondents adequately responded and were included in the analysis. The number (%) of female respondents was 79 (76.0%). The number (%) of respondents by decade was 17 (16.3%) in their 20s, 65 (62.5%) in their 30s, 19 (18.3%) in their 40s, and 3 (2.9%) in their 60s, respectively. Mean body mass index was 37.1 ± 6.3 kg/m2. Comorbidities were type 2 diabetes in 34 (32.7%) and hypertension in 35 (33.7%). The most favored procedure was sleeve gastrectomy (SG) in 78 (75.0%), adjustable gastric band (AGB) surgery in 12 (11.5%), Roux-en-Y gastric bypass (RYGB) in 6 (5.8%), and gastric plication (GP) in 8 (7.7%). Major reasons for choosing procedures were; “adjustable” for AGB, “stomach sparing” for GP, “excellent weight loss” for SG, and “comorbidity resolution” in RYGB. CONCLUSION Candidates for bariatric/metabolic surgery favored SG followed by AGB, GP, and RYGB, and their choices were compatible with current evidence-based clinical practice.

The purpose of this study was to identify the consciousness of biomedical ethics and attitudes toward human tissue donation and transplantation among participants and non-participants in the anatomy camp program. Data collection is made from one hundred and eighty-two students who were enrolled in one university nursing department, in B metropolitan city. Ninety-six students participated in the anatomy camp program, while eighty-six students did not participate in the anatomy camp program. The total mean scores of consciousness of biomedical ethics between participants (2.03/4) and non-participants (1.96/4) were significantly different (t=2.217, p≤.028). And the total mean scores of attitudes toward human tissue donation and transplantation between participants (3.49/5) and non-participants (3.31/5) were significantly different (t=4.579, p≤.000). There were statistically significant differences between two groups in sub-categories of consciousness of biomedical ethics: organ transplantation, artificial insemination.
Bioethics* ; Consciousness* ; Data Collection ; Humans ; Humans* ; Insemination, Artificial ; Nursing* ; Organ Transplantation ; Students, Nursing* ; Tissue and Organ Procurement* ; Transplants

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

Gastric surgery is one of the most frequently performed operations in Korea. Retroanastomotic hernia is a rare complication ingastric surgery. We experienced this hernia and herein report it with a review of the literature. A 69-year-old male patient suffered from periumbilical pain for 3 days. Positive physical findings were tenderness around the umbilicus and decreased bowel sound. Simple abdominal findings revealed a mechanical obstruction. This patient had a history of gastrectomy 13 years prior to admission. At operation field, we were able to find the defect consisting of the transverse mesocolon, stomach, jejunum and retroperituneum. In Korea, since its first report by Petersen, only a few reports about this hernia have been reported. After increased incidence of operations for morbid obesity, reports on retroanstomotic hernia have increased.
Aged ; Gastrectomy ; Hernia ; Humans ; Incidence ; Jejunum ; Korea ; Male ; Mesocolon ; Obesity, Morbid ; Stomach ; Umbilicus

Two avulsed ears attached by very narrow subcutaneous pedicles were repaired with only cutaneous sutures and showed complete survival. The results showed that the entire auricle could be fully vascularized by just a single small vascular branch. This clinical result is compatible with our previous findings in anatomical study concerning arterial supply of the auricle.
Ear ; Sutures

PURPOSE: The aims of this study were to identify prevalence and identify factors related to sarcopenic obesity among community-dwelling elderly women. METHODS: This is a secondary analysis of the prospective cohort study. Our analysis included 338 elderly women (≥65 years old) in South Korea as a part of the Community-dwelling Older Adult Health Cohort (COHC) Study (2014-2015). Sarcopenic obesity was defined as the Asian Working Group of Sarcopenia recommendations and upper two quintiles for percentage body fat. Logistic regression analysis was used to determine the factors related to sarcopenic obesity including chronic diseases, medications, stress, fatigue, depression, exercise, level of proteins on body compositions, smoking, and alcohol use. RESULTS: The prevalence of sarcopenic obesity was 6.2%. A lower protein on body compositions (OR 0.017, 95% CI 0.003-0.081, p<.001), a larger number of medications (OR 2.104, 95% CI 1.404-3.152, p<.001), and a higher level of fatigue (OR 1.255, 95% CI 1.023-1.541, p=.030) were related factors of sarcopenic obesity. CONCLUSION: The findings suggest that nutritional interventions focusing on protein intakes should be needed to prevent sarcopenic obesity among the elderly women. Polypharmacy issue for preventing adverse outcomes and level of fatigue as indicator for early identification are also considered to develop community prevention programs.

No abstract available.
Endometriosis* ; Female